Scope Procedure With Widening the Duct Opening

Nationwide rates for HCPCS 43262

A flexible scope is passed through the mouth to the point where the bile and pancreas ducts drain into the small intestine, and the muscular valve at that opening is cut to widen it. Widening the opening lets trapped stones pass, relieves blockage and gives access for further work inside the ducts. It is done under sedation, with no cut in the abdomen.

Rates data updated July 2026.

How much does Scope Procedure With Widening the Duct Opening cost?

$4,109

Typical total for the visit. Nationwide, July 2026.

Insurers have agreed to pay about $4,109 for this procedure. That total is two separate charges: $479 to the doctor who performs it, and $3,631 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

12% physician fee88% facility fee

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 62 insurance carriers under federal price transparency rules.

What's inside this number

Part of the bill	Who charges it	Typical	Range
Physician feeThe doctor who performs it	The doctor who performs it	$479	$355 to $724
Facility feeThe hospital or surgery center	The hospital or surgery center	$3,631	$1,148 to $6,457

How much rates vary

Facilitymedian $3,631 · 10th to 90th $501 to $10,000Professionalmedian $479 · 10th to 90th $316 to $1,585

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier	Facility/Professional	Modifier	Typical Low	Median	Typical High
Aetna Setting Facility Modifier Global Typical Low $562.34 Median $3,235.94 Typical High $8,912.51	Facility	Global	$562.34	$3,235.94	$8,912.51
BCBS Setting Facility Modifier Global Typical Low $2,238.72 Median $5,888.44 Typical High $13,803.84	Facility	Global	$2,238.72	$5,888.44	$13,803.84
Cigna Setting Facility Modifier Global Typical Low $549.54 Median $1,230.27 Typical High $3,467.37	Facility	Global	$549.54	$1,230.27	$3,467.37
Cigna Setting Facility Modifier 22 · Increased work Typical Low $660.69 Median $660.69 Typical High $660.69	Facility	22 · Increased work	$660.69	$660.69	$660.69
United Setting Facility Modifier Global Typical Low $1,023.29 Median $3,890.45 Typical High $9,772.37	Facility	Global	$1,023.29	$3,890.45	$9,772.37

What it costs in each state

The same service costs 7.4 times more in Wisconsin than in South Dakota. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Physician feeFacility fee

Touch or drag across the chart to see any state's rate.

WI $7,485SD $1,010

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.